The prescription of opoides analgesics: what preventive measures are taken by doctors to avoid their problematic use?

Introduction An opioid analgesic exposes you to a risk of problematic use, due to the terrain (vulnerability), its emotional state, the presence of pain and the environment and thus the opioid itself. The risk of developing an opioid use disorder when taking prescription opioids is approximately 3% (over 2 years), Objectives Recognize the method of prescription of opioids, as well as the elements to be sought by doctors during the interrogation and after each prescription of opioids Methods a descriptive and analytical study, based on a hetero-questionnaire completed by doctors, numbering 120 doctors who were consulted over a period of one year. the study was carried out via Google Forms. Results 75% of doctors are general practitioners. 90% of our doctors have a period of practice less than 10 years, and the lower half of 4 years, Almost all doctors prescribe opioid analgesics for pain of severe intensity, often of rheumatic origin 50%, neoplastic, post-operative or for a migraine or neuralgia. 9% of physicians think opioid painkillers have a high risk of addiction, almost 20% think opioid painkillers do not even have a risk of addiction, and the majority think the risk is low to moderatedoctors limit the duration of prescription 80%, sensitize their patients in 75%, half prescribe a low dose but the majority abruptly stop treatment. 70% of doctors limit the duration of prescription in less than 02 weeks, but 15% do not limit not prescribing opioids Conclusions The dose-efficacy-tolerance relationship is very variable from one patient to another, it is important to adapt the dosage gradually according to the intensity of the pain with monitoring of possible tolerance. Stopping should be done gradually to avoid a withdrawal syndromeThe prescription must systematically be accompanied by information to the patient about the treatment and its discontinuation, and monitoring of these risks even when it is prescribed in compliance with the conditions of the marketing authorization. Disclosure of Interest None Declared

Introduction: "Rust is one of the cruellest games on Steam, and that's what makes it so compelling."(PC Gamer) Rust is a multiplayer-only survival video game.It's full release was in 2018.The average age of a player is between 17 and 40 years.However, one must question the age group that enters the game and continues to play.This presentation will focus on adolescence, gaming addiction, insomnia, and the developing brain.Objectives: Rust is a game of round-the-clock survival in the wilderness whereby players must manage the basic essence of human need to "stay alive".However, it requires a player to be present for a consistent duration of time, or risk "dying".What does this mean for an adolescent, entering their final two years of school?What is their focus?How does this potentially affect the development of the young mind, still vulnerable to an immediate (real) world moulding a brain from adolescence to young adulthood?Methods: Questions regarding adolescent epigenetics, insomnia and addiction erupt in mental health when Rust and other international multiplayer survival games capture and imprison the mind of our youth.Results: The WHO added "gaming disorder" to the 2018 International Classification of Diseases.But the APA manual, the DSM-5, did not.The University of New Mexico suggests that 6-15% of all gamers exhibit signs and symptoms consistent of addiction.

EPV0024
The prescription of opoides analgesics: what preventive measures are taken by doctors to avoid their problematic use?
Introduction: An opioid analgesic exposes you to a risk of problematic use, due to the terrain (vulnerability), its emotional state, the presence of pain and the environment and thus the opioid itself.The risk of developing an opioid use disorder when taking prescription opioids is approximately 3% (over 2 years), Objectives: Recognize the method of prescription of opioids, as well as the elements to be sought by doctors during the interrogation and after each prescription of opioids Methods: a descriptive and analytical study, based on a heteroquestionnaire completed by doctors, numbering 120 doctors who were consulted over a period of one year.the study was carried out via Google Forms.Results: 75% of doctors are general practitioners.90% of our doctors have a period of practice less than 10 years, and the lower half of 4 years, Almost all doctors prescribe opioid analgesics for pain of severe intensity, often of rheumatic origin 50%, neoplastic, post-operative or for a migraine or neuralgia.9% of physicians think opioid painkillers have a high risk of addiction, almost 20% think opioid painkillers do not even have a risk of addiction, and the majority think the risk is low to moderatedoctors limit the duration of prescription 80%, sensitize their patients in 75%, half prescribe a low dose but the majority abruptly stop treatment.70% of doctors limit the duration of prescription in less than 02 weeks, but 15% do not limit not prescribing opioids Conclusions: The dose-efficacy-tolerance relationship is very variable from one patient to another, it is important to adapt the dosage gradually according to the intensity of the pain with monitoring of possible tolerance.Stopping should be done gradually to avoid a withdrawal syndromeThe prescription must systematically be accompanied by information to the patient about the treatment and its discontinuation, and monitoring of these risks even when it is prescribed in compliance with the conditions of the marketing authorization.

EPV0025
Prevalence of HIV infection in patients of a substance use treatment facility Introduction: According to domestic and foreign studies, in the last decade there has been an increase in the number of HIVinfected patients suffering from alcoholic disease.Under the influence of alcohol, the risk of infection and transmission of HIV infection increases, the course of the disease worsens.There is a syndemia between alcohol abuse and HIV infection.This requires new approaches to the tactics of managing patients of a narcological hospital with HIV infection.Objectives: To identify the prevalence of HIV infection in patients of the substance use treatment facility suffering from alcohol disease of the second stage.Methods: The authors analyzed 446 medical histories of patients suffering from alcoholic disease who underwent inpatient treatment in 2009-2021.For data processing, a statistical method for calculating relative indicators used.Results: The study showed that a significant proportion of patients with HIV infection were patients of working age 40-59 years.At the same time, since 2009, there has been an increase in HIV-infected patients from the total number of hospital patients.So, if in 2009 they were 1.2%, then in 2021 they were already 7.2%.Most HIVinfected patients of the narcological hospital are single or divorced.The study notes that abuse is common among patients with HIV infection as a means of combating depression.According to 2019 data, 39.0% of hospital patients suffer from depression.The authors show that alcohol affects the increase in risky forms of sexual relations, or risky situations with unprotected sex.In addition, with alcohol abuse, the viral load increases, and therefore the likelihood of transmitting HIV infection to a partner with unprotected sex increases.Conclusions: Alcohol abuse is a causative factor in HIV infection.Early detection of people with harmful alcohol consumption and referral to a psychiatrist will increase adherence to antiretroviral therapy, as well as reduce the rate of HIV infection Disclosure of Interest: None Declared EPV0026 N-Hexane neuropathy: from addiction to disability! Introduction: Voluntary poisoning with neurotoxic products in order to achieve euphoria is common especially among young people.Neurological complications are quite likely and can be serious and irreversible.Objectives: We aim to describe the peripheral neuropathies secondary to N-Hexane intoxication in a Tunisian population.Methods: A retrospective descriptive study was carried out in our department of neurology in the NationalInstitute of Neurology of Tunis including patients diagnosed with N-Hexane neuropathy.All patientshad a history of a N-Hexane exposure.The diagnosis was confirmed after excluding other etiologiesthrough appropriate investigations.Clinical and para-clinical data as well as follow-up were assessed.Results:We selected 38 patients with a mean age of 22.7 years .Among them, 37 were glue-sniffer and 1 had a voluntary toxic exposure to paint.An associated cannabis consumption was found in 6 patients.All of them had a low socioeconomic background and 17 were unemployed.Time to onset of neurological signs ranged from 5 months to 11 years.The clinical exam showed a quadriparesis (15,7%), a paraparesis (58%), sensory involvement (55,2%) amyotrophy (40%) and abolished tendon reflexes in lower limbs (81,5%).Swallowing disorder and optic neuritis were found in one case.The electroneuromyogram revealed an axono-demyelinating sensory-motor polyneuropathy (PN) in 16 cases and a demyelinating motor PN in 9 cases.Vitamin therapy, motor rehabilitation and psychotherapy sessions have been indicated.Only 6 patients showed slight clinical improvement after withdrawal.The rest of our patients did not quit; 84% of them became bedridden.Conclusions: Glue-sniffer related neuropathy is very common in our country especially in adolescents and young adults with low socio-economic background.The neurological outcome is serious and usually irreversible if exposure is persistent.

EPV0027
The impact of cocaine on diagnosis stability in psychosis, based on a case report Introduction: Substance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse, but persists for days and weeks with no substance use.There is growing recognition that individuals with substance-induced